Premise
The following indications are for information purposes EXCLUSIVELY and are not intended to replace the opinion of professional figures such as doctor, nutritionist or dietician, whose intervention is necessary for the prescription and composition of CUSTOMIZED food therapies.
Sodium and hypertension
Excess sodium is the most important nutritional factor involved in the increase of blood pressure and in the onset of hypertension in predisposed subjects.
In addition to being a disease in its own right, hypertension is a risk factor for the diagnosis of metabolic syndrome, a pathological complex that dramatically increases the risk of ischemic heart disease and / or cerebral vascular syndrome.
NB . The combination of type 2 diabetes mellitus and arterial hypertension significantly increases its harmfulness to the body.
Hyposodic diet
The hyposodic diet is a dietary therapy characterized by a low sodium intake, aimed at reducing blood pressure in subjects with arterial hypertension.
Originally, the hyposodic diet had as its main characteristic the limitation of foods containing added sodium or table salt and the abolition of the so-called "discretionary" salt (the one added at home). Today, the hyposodic diet is a much more complex dietary scheme; first of all, the hyposodic diet is often also a low-calorie diet, this is due to the fact that many cases of hypertension recognize a multiple etiology, among which the excessive accumulation of adipose tissue (overweight and obesity) stands out with an increase in the Mass Index Body (> BMI or BMI, often in the abdominal area).
Moreover, the hyposodic diet can be corrected on the basis of other existing pathologies, in order to make it effective even in restoring the other compromised metabolic parameters; in many cases, the hyposodic diet thus evolves into an anti-metabolic syndrome diet.
The most useful and frequent devices to be used in the composition of a hyposodic "anti-metabolic syndrome" diet are:
- Elimination of discretionary salt and all foods containing added sodium
- Right amount of energy based on body composition
- Moderation of load and glycemic index, to reduce glycaemia and triglyceridemia
- Moderation of dietary cholesterol and reduction of LDL circulating in the blood
- Increase of unsaturated fatty acids belonging to the ω3 family and (if necessary) also of ‰ ω6 and ω ‰ 9, to the detriment of saturated and / or hydrogenated fatty acids; the effect can be translated into a reduction in arterial pressure and triglycerides, with lowering of total cholesterol and / or LDL, and sometimes an increase in HDL
- Increased water, dietary fiber, phenolic substances, vegetable lecithins, phytosterols, antioxidant vitamins and antioxidant or useful mineral salts (potassium, magnesium and calcium) to: reduce cholesterol absorption and improve metabolism, reduce total oxidative stress and improve sodium / potassium balance to the benefit of blood pressure
- Moderation / elimination of nerves such as: caffeine, theine, other stimulants present in energy drinks, ethyl alcohol, etc.
Furthermore, it is advisable to associate the hyposodic diet with: abolition of smoking, reduction of excessively stressful situations and start-up of an open-ended physical and aerobic and anaerobic physical activity protocol.
In summary, the hyposodic diet is aimed not only at the moderation of arterial pressure but also at the reduction of overall cardiovascular risk, especially in the presence of other risk factors for ischemic heart disease and cerebral vascular syndrome (facilitated by atherosclerosis and hypertension or by hereditary factors such as aneurysms). NB . The hyposodic diet may also need the right precautions for the prevention of hyperuricemia or gouty attacks in predisposed subjects, but it is a rather peculiar and specific therapy.
In practice, the low-salt diet aimed at compensating for hypertension and other predisposing metabolic parameters (overweight, hypercholesterolemia, hyperglycemia or diabetes, hypertriglyceridemia, high oxidative stress, etc.) is structured as follows:
- Elimination of table salt and preserved foods (salami, aged cheeses, canned foods, etc.); allowed only chilled and frozen foods
- Reduction of at least 1/3 of all portions with the exception of vegetables
- Reduction of the portions of: starchy or highly glucidic foods such as pasta, bread and potatoes, of preserved fruit such as jams, canned fruit, dehydrated fruit etc., and of high-calorie fruit such as ripe banana, kaki, figs, grapes, mandarins, etc. . NB : It is better to REPLACE refined farinaceous foods with INTEGRAL ones
- Abolition of fatty meats, aged cheeses and egg yolks, drastic reduction of meats, cheeses and eggs in general in favor of fishery products and in particular blue fish (fresh tuna, allotato, amberjack, bonito, greenhouse, leccia, lampuga, mackerel, lanzardo, alice, sarda, herring, needlefish, boga etc.)
- Replacement of any seasoning or saturated or hydrogenated fat with vegetable oils; use of extra virgin olive oil for cooking and (if desired) oils rich in ω- ‰ 3 to season raw (soy, kiwi, grapeseed, walnut, flax etc.). NB : the use of dried fruit provides essential fatty acids BUT it must be balanced with respect to the total fat intake; for every 10g of dried fruit it is necessary to eliminate 5g of oil
- Significant increase in portions of fresh and cooked vegetables; if absent, integration of fresh fruit with peel
- Abolition of energy drinks and spirits; drastic moderation of coffee, tea and red wine at main meals
- If possible, use low-salt water.
Useful supplements in the sodium diet
The useful supplements to the sodium diet to decrease blood pressure are:
- Potassium: which has an effect opposite to that of sodium
- Polyunsaturated fatty acids of the ω-3 family, possibly EPA and DHA (biologically more active), which have the effect of reducing blood pressure, systemic inflammation and hyperlipidemia
- Arginine amino acid
- Plants, extracts and diuretic and / or hypotensive vegetal derivatives.
The hyposodic and low calorie diet may need to be combined with some generic food supplements; this is justifiable by the fact that in the more restrictive regimes, often the relative food portions are not sufficient to reach the recommended rations for mineral salts and / or vitamins.
Diet against hypertension: Example
- Postal employee, hypertensive, non-physical motor activity, quit smoking but doing so has gained a lot of weight. He likes aperitifs and doesn't have breakfast. Autumn-winter season.
| Sex | F | |||
| Age | 53 years old | |||
| Stature cm | 158 cm | |||
| Wrist circumference cm | 14.8 cm | |||
| Constitution | thin | |||
| Stature / wrist | 10.7 | |||
| Morphological type | normolineo | |||
| Weight kg | 85.0Kg | |||
| Body mass index | 34.1 | |||
| Rating | obese | |||
| Desirable physiological body mass index | 22.0 | |||
| Desirable physiological weight kg | 48.2Kg | |||
| Basal kcal metabolism | 1248.0Kcal | |||
| Coefficient of physical activity level | 1:42 | |||
| Kcal energy expenditure | 1772.4kcal | |||
| Diet | IPO SODICA / IPO CALORICA -30% | 1240Kcal | ||
| Lipids | 25% | 310.0kcal | 34.4g | |
| Protein | > 0.8 and <1.5g / kg | Average 289.2kcal | Average 72.3g | |
| Carbohydrates | 51.7% | 640.8kcal | 170.9 g | |
| Breakfast | 15% | 186kcal | ||
| Snack | 10% | 124kcal | ||
| Lunch | 35% | 434kcal | ||
| Snack | 10% | 124kcal | ||
| Dinner | 30% | 372kcal | ||
Example Low-salt Diet - Day 1
| Breakfast, about 15% of the daily energy | |||
| Skimmed cow's milk | 200, 0ml | 72, 0kcal | |
| Muesli with dried fruit and hazelnuts | 30, 0g | 102, 0kcal | |
| Snack 1, about 10% of the daily energy | |||
| Apple | 150, 0g | 78, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Lunch, about 35% of the daily energy | |||
| Whole wheat pasta with tomato | |||
| Integral semolina pasta | 80, 0g | 259, 2kcal | |
| Tomato sauce | 100, 0g | 24, 0kcal | |
| Grated Parmesan) | 10.0g | 38, 1kcal | |
| Extra virgin olive oil | 5.0g | 45, 0kcal | |
| Lettuce | 50, 0g | 9, 0kcal | |
| Soybean oil | 5.0g | 44, 2kcal | |
| Snack 2, about 10% of the daily energy | |||
| Orange | 150, 0g | 51, 0kcal | |
| Skim milk yogurt | 125, 0g | 45, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Dinner, about 30% of the daily energy | |||
| Anchovies in the pan | |||
| Anchovies or anchovies | 200, 0g | 192, 0kcal | |
| Zucchini (in a pan) | 200, 0g | 32, 0kcal | |
| Extravirgin olive oil | 10.0g | 90, 0kcal | |
| Whole grain bread | 25, 0g | 60, 8kcal | |
| DAY 1 nutritional translation | ||
| Nourishing or nutritional component | Quantity | |
| Power | 1251.75kcal | |
| Food water | 1055.88g | |
| Protein | 72.95g | |
| Total lipids | 35.83g | |
| Saturated fats, total | 8.34g | |
| Total monounsaturated fatty acids | 16.17g | |
| Total polyunsaturated fatty acids | 8.90g | |
| Cholesterol | 157.50mg | |
| Carbohydrates | 177.27g | |
| Simple sugars, total | 69.85g | |
| Alcohol, ethanol | 00:00 | |
| fibers | 26.67g | |
| Sodium | 1546.80mg | |
| Potassium | 3132.75mg | |
| Football | 975.45mg | |
| Iron | 16.2mg | |
| Phosphorus | 1351.10mg | |
| Zinc | 11.09mg | |
| Thiamine or vit. B1 | 1.72mg | |
| Riboflavin or vit. B2 | 2.08mg | |
| Niacin or vit. B3 or vit. PP | 41.73mg | |
| Pyridoxine or vit. B6 | 2.33mg | |
| Folate, total | 169.4μg | |
| Ascorbic acid or vit. C | 135.90mg | |
| Retinol equivalent activities or vit. TO | 397.20RAE | |
| α-tocopherol or vit. IS | 14.79mg | |
In BLUE : the perfect achievement of some desirable recommended rations of the most IMPORTANT nutritional components for the IPOsodic, IPOcaloric and PREVENTIVE diet against metabolic diseases (weighted for the specific case).
In YELLOW : the contribution of total fibers that, in an optimal way, should be around 30g / day; obviously, as this is a single day translation, it is not possible to show the weekly average in which legumes and other vegetables (more fiber-rich than the foods in the example) would fit.
In RED : the contribution of simple TOTAL carbohydrates which, based on the recommendations, should be lower than the value obtained of 2-10%. However, considering the nature of existing carbohydrates (exclusively intrinsic and non-added fructose and lactose), it is possible to state that the glycemic index (GI) and the glycemic load (CG) of individual foods and meals are more than suitable. After all, consider that fructose (which represents most of the simple carbohydrates mentioned above) enjoys the lowest GI of the available carbohydrates. The same amount of simple sugars contextualized in a low-salt but NORMO-caloric diet would have determined a lower ratio and suitability for dietary recommendations; therefore, it is an exclusively proportional issue.
Following we will report the rest of the weekly hyposodic and low-calorie example for the subject under examination.
Example Low-salt Diet - Day 2
| Breakfast, about 15% of the daily energy | |||
| Soy milk enriched in vitamins A, D and calcium | 200, 0ml | 54, 0kcal | |
| Muesli with dried fruit and hazelnuts | 30, 0g | 102, 0kcal | |
| Snack 1, about 10% of the daily energy | |||
| Pear | 150, 0g | 87, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Lunch, about 35% of the daily energy | |||
| Champignon mushroom risotto | |||
| Long grain brown rice | 70, 0g | 259, 0kcal | |
| Champignon mushrooms | 100, 0g | 22, 0kcal | |
| Grated Parmesan) | 10.0g | 38, 1kcal | |
| Extra virgin olive oil | 5.0g | 45, 0kcal | |
| Radicchio | 50, 0g | 11, 5kcal | |
| Soybean oil | 5.0g | 44, 2kcal | |
| Snack 2, about 10% of the daily energy | |||
| Grapefruit (pink, red and white) | 150, 0g | 48, 0kcal | |
| Skim milk yogurt | 125, 0g | 45, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Dinner, about 30% of the daily energy | |||
| Grilled yellow tail fish | |||
| Amberjack or Pompano | 150, 0g | 219, 0kcal | |
| Eggplant (in a pan) | 200, 0g | 48, 0kcal | |
| Extravirgin olive oil | 5.0g | 45, 0kcal | |
| Whole grain bread | 25, 0g | 60, 8kcal | |
Example Low-salt Diet - Day 3
| Breakfast, about 15% of the daily energy | |||
| Skimmed cow's milk | 200, 0ml | 72, 0kcal | |
| Muesli with dried fruit and hazelnuts | 30, 0g | 102, 0kcal | |
| Snack 1, about 10% of the daily energy | |||
| Kiwi | 150, 0g | 91, 5kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Lunch, about 35% of the daily energy | |||
| Bean soup with carrots | |||
| Dried borlotti beans | 80, 0g | 248, 8kcal | |
| carrots | 50, 0g | 20, 5kcal | |
| Grated Parmesan) | 10.0g | 38, 1kcal | |
| Extra virgin olive oil or soybean oil TOT | 10.0g | 90, 0kcal | |
| Snack 2, about 10% of the daily energy | |||
| Winter melon | 150, 0g | 42, 0kcal | |
| Skim milk yogurt | 125, 0g | 45, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Dinner, about 30% of the daily energy | |||
| Grilled chicken breast | |||
| Chicken breast, only meat | 200, 0g | 220, 0kcal | |
| Extravirgin olive oil | 5.0g | 90, 0kcal | |
| Fennel (raw) | 200, 0g | 18, 0kcal | |
| Soybean oil | 5.0g | 44, 2kcal | |
| Whole grain bread | 25, 0g | 60, 8kcal | |
Example Low-salt Diet - Day 4
| Breakfast, about 15% of the daily energy | |||
| Soy milk enriched in vitamins A, D and calcium | 200, 0ml | 54, 0kcal | |
| Muesli with dried fruit and hazelnuts | 30, 0g | 102, 0kcal | |
| Snack 1, about 10% of the daily energy | |||
| Apple | 150, 0g | 78, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Lunch, about 35% of the daily energy | |||
| Whole wheat pasta with peppers | |||
| Integral semolina pasta | 80, 0g | 259, 2kcal | |
| peppers | 100, 0g | 22, 0kcal | |
| Grated Parmesan) | 10.0g | 38, 1kcal | |
| Extra virgin olive oil | 5.0g | 45, 0kcal | |
| Belgian endive | 50, 0g | 8, 5kcal | |
| Soybean oil | 5.0g | 44, 2kcal | |
| Snack 2, about 10% of the daily energy | |||
| Orange | 150, 0g | 51, 0kcal | |
| Skim milk yogurt | 125, 0g | 45, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Dinner, about 30% of the daily energy | |||
| Carpaccio of fillet of red tuna | |||
| Red tuna fillet, low in temperature | 200, 0g | 216 kcal | |
| Cabbage | 200, 0g | 50, 0kcal | |
| Extravirgin olive oil | 10.0g | 90, 0kcal | |
| Whole grain bread | 25, 0g | 60, 8kcal | |
Example Low-salt Diet - Day 5
| Breakfast, about 15% of the daily energy | |||
| Skimmed cow's milk | 200, 0ml | 72, 0kcal | |
| Muesli with dried fruit and hazelnuts | 30, 0g | 102, 0kcal | |
| Snack 1, about 10% of the daily energy | |||
| Pear | 150, 0g | 87, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Lunch, about 35% of the daily energy | |||
| Rocket risotto | |||
| Long grain brown rice | 70, 0g | 259, 0kcal | |
| Rocket salad | 100, 0g | 12, 5kcal | |
| Grated Parmesan) | 10.0g | 38, 1kcal | |
| Extra virgin olive oil | 5.0g | 45, 0kcal | |
| Valerian | 50, 0g | 10, 5kcal | |
| Soybean oil | 5.0g | 44, 2kcal | |
| Snack 2, about 10% of the daily energy | |||
| Grapefruit (pink, red and white) | 150, 0g | 48, 0kcal | |
| Skim milk yogurt | 125, 0g | 45, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Dinner, about 30% of the daily energy | |||
| Steamed angler fish | |||
| Monkfish | 200, 0g | 126, 0kcal | |
| Broccoli (steamed) | 200, 0g | 68, 0kcal | |
| Extra virgin olive oil or soybean oil TOT | 15, 0g | 135, 0kcal | |
| Whole grain bread | 25, 0g | 60, 8kcal | |
Example Low-salt Diet - Day 6
| Breakfast, about 15% of the daily energy | |||
| Soy milk enriched in vitamins A, D and calcium | 200, 0ml | 54, 0kcal | |
| Muesli with dried fruit and hazelnuts | 30, 0g | 102, 0kcal | |
| Snack 1, about 10% of the daily energy | |||
| Kiwi | 150, 0g | 91, 5kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Lunch, about 35% of the daily energy | |||
| Chickpea soup with celery | |||
| Chickpeas, dried | 80, 0g | 267, 2kcal | |
| Celery | 200, 0g | 32, 0kcal | |
| Grated Parmesan) | 10.0g | 38, 1kcal | |
| Extra virgin olive oil or soybean oil TOT | 10.0g | 90, 0kcal | |
| Snack 2, about 10% of the daily energy | |||
| Winter melon | 150, 0g | 42, 0kcal | |
| Skim milk yogurt | 125, 0g | 45, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Dinner, about 30% of the daily energy | |||
| Ricotta cheese | |||
| Cow ricotta | 120, 0g | 163, 2kcal | |
| Potato (boiled) | 100, 0g | 85, 0kcal | |
| Extra virgin olive oil or soybean oil TOT | 10.0g | 90kcal | |
| Whole grain bread | 25, 0g | 60, 8kcal | |
Example Low-salt Diet - Day 7
| Breakfast, about 15% of the daily energy | |||
| Skimmed cow's milk | 200, 0ml | 72, 0kcal | |
| Muesli with dried fruit and hazelnuts | 30, 0g | 102, 0kcal | |
| Snack 1, about 10% of the daily energy | |||
| Apple | 150, 0g | 78, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Lunch, about 35% of the daily energy | |||
| Whole wheat pasta with zucchini | |||
| Integral semolina pasta | 80, 0g | 259, 2kcal | |
| Zucchini | 100, 0g | 16, 0kcal | |
| Grated Parmesan) | 10.0g | 38, 1kcal | |
| Extra virgin olive oil | 5.0g | 45, 0kcal | |
| Lettuce | 50, 0g | 9, 0kcal | |
| Soybean oil | 5.0g | 44, 2kcal | |
| Snack 2, about 10% of the daily energy | |||
| Orange | 150, 0g | 51, 0kcal | |
| Skim milk yogurt | 125, 0g | 45, 0kcal | |
| Wholemeal rusks | 15, 0g | 54, 8kcal | |
| Dinner, about 30% of the daily energy | |||
| Egg and egg omelette | |||
| Whole chicken egg | 60, 0g | 85, 0kcal | |
| Egg whites | 200, 0g | 96, 0kcal | |
| Stewed artichokes) | 200, 0g | 94, 0kcal | |
| Extravirgin olive oil | 10.0g | 90, 0kcal | |
| Whole grain bread | 25, 0g | 60, 8kcal | |
